A new international consensus report on precision medicine in diabetes prevention and care has been published in Nature Medicine.
The report, with Dr Siew Lim, from Monash University’s Eastern Health Clinical School, as the co-senior lead, highlights the importance of precision diabetes medicine in clinical practice, while also emphasising the critical knowledge gaps that must be addressed.
Supported by the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD) and the Novo Nordisk Foundation, the consensus report was made possible through a huge collaborative effort involving 200 academic experts from 28 countries under the banner of the Precision Medicine in Diabetes Initiative (PMDI).
The report, which is the second international consensus report on precision diabetes medicine, highlights significant advancements in the adoption of precision medicine in diabetes prevention, diagnosis, treatment and prognosis while also shedding light on numerous knowledge gaps.
Diabetes affects hundreds of millions worldwide, many of whom will develop life-threatening complications and die prematurely. According to the report, diabetes poses a substantial risk of life-threatening complications and premature death.
“What adds to the complexity is the heterogeneous nature of diabetes, encompassing various causes, clinical manifestations, and prognoses. The heterogeneity underscores the need for more precise diagnostic, prevention and treatment strategies than exist today.”
The consensus report shows clear progress in implementing precision diabetes medicine, shedding light on opportunities for its immediate or near-term clinical application, such as in diagnosing and treating monogenic diabetes.
Precision medicine also shows potential in the prevention of gestational diabetes. According to Dr Lim, specific maternal characteristics have been identified as predictive factors for the success or failure of prevention; these include age, BMI, having polycystic ovary syndrome and a history of gestational diabetes.
“Given the potentially greater effectiveness of lifestyle or metformin interventions in certain individuals, future research on tailored recommendations in precision GDM prevention, replacing the current ‘one-size-fits-all’ approach, is needed,” Dr Lim said.
“While the consensus report highlights areas where precision medicine can have an impact in clinical practice, it also draws attention to research gaps and the need for improved research methods.”
Professor Paul Franks, chair of the report and Scientific Director in Medical Science and Head of Translational Medicine at the Novo Nordisk Foundation said there is a large body of work that lies ahead.
“There is a big need for better reporting standards, study design standards, and specifically designed precision medicine trials,” Professor Franks said.
“The consensus report provides a framework for what future research should focus on.”